Needle exchange, HIV, and the feds

Going back to the 1980s, the federal government has been spending money to combat the spread of HIV and AIDS. For most of that time, the effort excluded state and local programs to provide drug users with clean syringes -- even though study after study proved they were highly effective.

Given the choice of using dirty needles to inject drugs or using sterile ones, addicts generally prefer the latter. And every one who makes that choice cuts off an avenue for the transmission of the AIDS virus. These programs curb the epidemic without stimulating more drug use. They also protect unwitting innocents whose sexual partners might contract the virus through contaminated syringes.

The evidence is not really in dispute. The National Institutes of Health Consensus Panel on HIV Prevention has said, "An impressive body of evidence suggests powerful effects from needle exchange programs....Studies show reduction in risk behavior as high as 80%, with estimates of a 30% or greater reduction of HIV in IDUs (intravenous drug users)." It also concluded they are cost effective.

In 2009, President Obama signed a bill letting states and cities use federal money to underwrite these efforts. But in the spending package now before Congress, Republicans have managed to restore the old ban.

It's a triumph of ideology over experience, and it would be a tragedy in practice. Needle exchanges have saved lives. Reviving the prohibition would have a sure effect: killing people.